Hand Dermatitis: A Review of Clinical Features, Diagnosis, and Management

Deborah A. Kedrowski, RN; Erin M. Warshaw, MD, MS

Disclosures

Dermatology Nursing. 2008;20(1):17-25. 

In This Article

Abstract and Introduction

Abstract

Hand dermatitis is a common skin condition among all ages and both genders. Diagnosis, treatment, lifestyle changes, and an overall understanding of this condition are important in controlling severity and outcomes.

Introduction

The skin of the hands provides significant protection against the majority of natural and synthetic harmful substances. Hand dermatitis (HD), also known as hand eczema, is a common dermatologic disorder (Warshaw, Lee, & Storrs, 2003). It is a frequent problem among individuals who perform "wet work" such as homemakers, bartenders, hairdressers, dental workers, and health care workers; repetitive wetting and drying of the hands leads to dryness and redness. HD is also prevalent among those exposed to various irritants or allergens, and after prolonged periods of exposure, individuals may experience scaling, fissuring, cracking, itching, and crusting. For those patients who cannot avoid the common triggers of HD, or for those with a predisposition to it, education is imperative for quality of life. Education begins with a basic understanding of HD and the most likely triggers.

There are four main subtypes of HD: contact dermatitis (irritant or al lergic dermatitis), atopic hand dermatitis, pomphylox (dyshidrotic ec zema), and hyperkeratotic dermatitis (Warshaw et al., 2003) (see Table 1 ). The terms eczema and dermatitis are often used synonymously and are used interchangeably (Bourke, Coulson, & English, 2001). It is important to note that most hand eczemas are often a mixture or hybrid of various clinical subtypes (Warshaw et al., 2003).

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